In the evaluation of patient status and progress, numerous physical performance tests have been developed and approximately standardized over the years. The objective of these tests is to provide comparable measurements which can be correlated with the observable effects of conditions on patients. Specifically, the goal of such tests is to quantitatively measure a person's mobility and physical performance. As physical performance is highly associated with quality of life and risk of falling, accurate monitoring of physical performance in older adults is necessary and important.
The Timed Up and Go (TUG) test is a simple test used to assess a person's mobility. To perform the test well, it requires both static and dynamic balance, strength, vision, and cognition. The test measures the time that a person takes to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down. The TUG is used frequently in the elderly population, as it is easy to administer and can generally be completed by most older adults.
One source suggests that scores of 10 seconds or less from a TUG test indicate normal mobility, 11-20 seconds are within normal limits for frail elderly and disabled patients, and greater than 20 seconds means the person needs assistance outside and indicates further examination and intervention. A score of fourteen seconds or more suggests that the person may be prone to falls. Alternatively, a recommended practical cut-off value for the TUG to indicate normal versus below normal performance is 12 seconds. A study by Bischoff et al. showed the 10th to 90th percentiles for TUG performance were 6.0 to 11.2 seconds for community-dwelling women between 65 and 85 years of age, and determined that this population should be able to perform the TUG in 12 seconds or less. Bischoff et al. “Identifying a cut-off point for normal mobility: A comparison of the timed ‘up and go’ test in community-dwelling and institutionaliseds elderly women”. Age and Ageing 32 (3): 315-20. TUG performance has been found to decrease significantly with mobility impairments. Residential status and physical mobility status have been determined to be significant predictors of TUG performance.
Research has shown the TUG test has excellent interrater (interclass correlation coefficient (ICC)=0.99) and intrarater reliability (ICC=0.99). The test score also correlates well with gait speed (r=−55), scores on the Berg Balance Scale (r=−0.72), and the Barthel Index (r=−0.51). Many studies have shown good test-retest reliability in specific populations such as community-dwelling older adults and people with Parkinson's disease.
The Timed Up-and-Go Test Procedure:
The height of a chair or bench is adjusted so that when the subject is seated on the chair or bench, his or her feet are flat on the floor with knees flexed at 90 degrees. Once positioned, the standardized procedure for the TUG test is followed. Subjects are observed and timed from the instant they rise from the chair or bench, walk a fixed distance (3, 6, or 9 meters), navigate around an obstacle on the floor (i.e. a cone), and return to a fully seated position in the chair or bench. Subjects wear their regular footwear and foot orthotic(s) during this test.
Subjects are instructed to be seated and ready for the test on the word “ready”, and begin the test on the word “go”. The goal of the test is to “stand up, walk at a fast pace, turn, and walk at a fast pace back to the bench and sit down.” A test administrator records the time using a stop-watch. Another test administrator makes sure that the data are recorded and exported successfully. Typically, three trials are collected from each subject.